REVIEW ARTICLE
A narrative review of cutaneous manifestations and imaging landmarks of breast cancer
 
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1
Faculty of Medicine and Pharmacy, Dunarea de Jos University, Galati, ROMANIA
 
2
Emergency County Hospital “Sf. Apostol Andrei” Galati, Galati, ROMANIA
 
3
Clinical Infectious Diseases Hospital Galati, Galati, ROMANIA
 
4
Carol Davila University of Medicine and Pharmacy, Bucuresti, ROMANIA
 
 
Publication date: 2024-01-16
 
 
Electron J Gen Med 2024;21(1):em566
 
KEYWORDS
ABSTRACT
Breast cancer is the most prevalent form of malignancy among women worldwide. Breast cancer can emerge on the skin in two ways: directly, as skin metastases or a direct extension of the tumor; or indirectly, as a paraneoplastic disease. Breast cancer imaging is an essential part of breast cancer screening, diagnosis, preoperative/treatment assessment, and follow-up. The selection of optimal imaging modalities should be contingent upon the patient’s risk factors and breast density since breast cancer imaging necessitates a personalized approach rather than a universal solution. There are a lot of different skin conditions that point to breast cancer, either as a sign of recurring disease, undiagnosed breast cancer, or a condition that puts you at a higher risk of getting it. Even though reconstruction has been shown to improve quality of life for many women, there are still a lot of complicated factors that affect morbidity and results.
 
REFERENCES (74)
1.
National Cancer Institute. National cancer stat facts: Female breast cancer. Available at: https://seer.cancer.gov/statfa... (Accessed: 7 November 2023).
 
2.
Duggan C, Trapani D, Ilbawi AM, et al. National health system characteristics, breast cancer stage at diagnosis, and breast cancer mortality: A population-based analysis. Lancet Oncol. 2021;22(11):1632-42. https://doi.org/10.1016/S1470-... PMid:34653370.
 
3.
Harbeck N, Penault-Llorca F, Cortes J, et al. Breast cancer. Nat Rev Dis Primers. 2019;5(1):66. https://doi.org/10.1038/s41572... PMid:31548545.
 
4.
Cardoso F, Paluch-Shimon S, Senkus E, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol. 2020;31(12):1623-49.
 
5.
Fietz T, Tesch H, Rauh J, et al. Palliative systemic therapy and overall survival of 1,395 patients with advanced breast cancer–Results from the prospective German TMK cohort study. Breast. 2017;34:122-30. https://doi.org/10.1016/j.brea... PMid:28586735.
 
6.
Gobbini E, Ezzalfani M, Dieras V, et al. Time trends of overall survival among metastatic breast cancer patients in the real-life ESME cohort. Eur J Cancer. 2018;96:17-24. https://doi.org/10. 1016/j.ejca.2018.03.015 PMid:29660596.
 
7.
Deluche E, Antoine A, Bachelot T, et al. Contemporary outcomes of metastatic breast cancer among 22,000 women from the multicentre ESME cohort 2008-2016. Eur J Cancer. 2020;129:60-70. https://doi.org/10.1016/j.ejca... PMid:32135312.
 
8.
Menes TS, Coster D, Coster D. Contribution of clinical breast exam to cancer detection in women participating in a modern screening program. BMC Womens Health. 2021; 21(1):368. https://doi.org/10.1186/s12905... PMid:34666735 PMCid:PMC8524962.
 
9.
Niell BL, Freer PE, Weinfurtner RJ, et al. Screening for breast cancer. Radiol Clin North Am. 2017;55(6):1145-62. https://doi.org/10.1016/j.rcl.... PMid:28991557.
 
10.
Schünemann HJ, Lerda D, Quinn C, et al. Breast cancer screening and diagnosis: A synopsis of the European breast guidelines. Ann Intern Med. 2020;172(1):46-56. https://doi.org/10.7326/M19-21... PMid:31766052.
 
11.
Stefanopol IA, Baroiu L, Neagu AI, et al. Clinical, imaging, histological and surgical aspects regarding giant paraovarian cysts: A systematic review. Ther Clin Risk Manag. 2022;18:513-22. https://doi.org/10.2147/TCRM.S... PMid:35516165 PMCid:PMC9064068.
 
12.
Moy L, Heller SL, Bailey L, et al. ACR appropriateness criteria(®) palpable breast masses. J Am Coll Radiol. 2017; 14(5S):S203-24. https://doi.org/10.1016/j.jacr... PMid:28473077.
 
13.
Vasile CI, Vasile MC, Zlati ML, et al. Post COVID-19 infection psychosis: Could SARS-CoV-2 virus infection be a neuropsychiatric condition that triggers psychotic disorders?–A case-based short review. Infect Drug Resist. 2022;15:4697-705. https://doi.org/10.2147/IDR.S3... PMid:36034176 PMCid:PMC9416515.
 
14.
D’Orsi CJ SE, Mendelson EB, Morris EA, et al. ACR BI-RADS atlas, breast imaging reporting and data system. Reston, (VA): American College of Radiology; 2013.
 
15.
Ikeda D, Miyake KK. Breast imaging: The requisites. St. Louis (MI): Elsevier; 2017.
 
16.
Steyerova P, Burgetova A. Current imaging techniques and impact on diagnosis and survival–A narrative review. Ann Breast Surg. 2021;6. https://doi.org/10.21037/abs-2....
 
17.
Hooley RJ, Scoutt LM, Philpotts LE. Breast ultrasonography: State of the art. Radiology. 2013; 268(3):642-59. https://doi.org/10.1148/radiol... PMid:23970509.
 
18.
American College of Radiology. ACR practice parameter for the performance of contrast-enhanced magnetic res- onance imaging (MRI) of the breast. Available at: https://www.acr.org/-/media/ac... (Accessed: 7 November 2023).
 
19.
Mann RM, Cho N, Moy L. Breast MRI: State of the art. Radiology. 2019;292(3):520-36. https://doi.org/10.1148/radiol... PMid:31361209.
 
20.
Plana MN, Carreira C, Muriel A, et al. Magnetic resonance imaging in the preoperative assessment of patients with primary breast cancer: Systematic review of diagnostic accuracy and meta-analysis. Eur Radiol. 2012;22(1):26-38. https://doi.org/10.1007/s00330... PMid:21847541.
 
21.
Bick U, Trimboli RM, Athanasiou A, et al. Image-guided breast biopsy and localisation: Recommendations for informa- tion to women and referring physicians by the European Society of Breast Imaging. Insights Imaging. 2020;11(1):12. https://doi.org/10.1186/s13244... PMid:32025985 PMCid:PMC7002629.
 
22.
Spencer PS, Helm TN. Skin metastases in cancer patients. Cutis. 1987;39(2):119-21.
 
23.
Krathen RA, Orengo IF, Rosen T. Cutaneous metastasis: A meta-analysis of data. South Med J. 2003;96(2):164-7. https://doi.org/10.1097/01.SMJ... PMid:12630642.
 
24.
Brownstein MH, Helwig EB. Metastatic tumors of the skin. Cancer. 1972;29(5):1298-307. https://doi.org/10.1002/1097-0...<1298::AID-CNCR2820290526>3.0.CO;2-6 PMid:4336632.
 
25.
Wong CY, Helm MA, Kalb RE, Helm TN, Zeitouni NC. The presentation, pathology, and current management strategies of cutaneous metastasis. N Am J Med Sci. 2013; 5(9):499-504. https://doi.org/10.4103/1947-2... PMid:24251266 PMCid:PMC3818821.
 
26.
Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol. 1990; 22(1):19-26. https://doi.org/10.1016/0190-9... PMid:2298962.
 
27.
Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: A retrospective study of 4020 patients. J Am Acad Dermatol. 1993;29(2 Pt 1):228-36. https://doi.org/10.1016/0190-9... PMid:8335743.
 
28.
De Giorgi V, Grazzini M, Alfaioli B, et al. Cutaneous manifestations of breast carcinoma. Dermatol Ther. 2010;23(6):581-9. https://doi.org/10.1111/j.1529... PMid:21054704.
 
29.
Mordenti C, Peris K, Concetta Fargnoli M, et al. Cutaneous metastatic breast carcinoma. Acta Dermatovenerologica. 2000;9(4):143-8.
 
30.
Nwabudike LC, Tatu AL. Magistral prescription with silver nitrate and peru balsam in difficult-to-heal diabetic foot ulcers. Am J Ther. 2018;25(6):e679-80. https://doi.org/10.1097/MJT.00... PMid:28614088.
 
31.
Mullinax K, Cohen JB. Carcinoma en cuirasse presenting as keloids of the chest. Dermatol Surg. 2004;30(2 Pt 1):226-8. https://doi.org/10.1111/j.1524... PMid:14756657.
 
32.
Carlesimo M, Rossi A, De Marco G, et al. Carcinoma en cuirasse of the breast. Eur J Dermatol. 2009;19:289-0. https://doi.org/10.1684/ejd.20... PMid:19557891.
 
33.
Mallon E, Dawber RP. Alopecia neoplastica without alopecia: A unique presentation of breast carcinoma scalp metastasis. J Am Acad Dermatol. 1994;31(2 Pt 2):319-21. https://doi.org/10.1016/S0190-... PMid:8034796.
 
34.
Valencia IC, Colsky A, Berman B. Multicentric reticulohistiocytosis associated with recurrent breast carcinoma. J Am Acad Dermatol. 1998;39(5 Pt 2):864-6. https://doi.org/10.1016/S0190-... PMid:9810917.
 
35.
Bennàssar A, Mas A, Guilabert A, Julià M, Mascaró-Galy JM, Herrero C. Multicentric reticulohistiocytosis with elevated cytokine serum levels. J Dermatol. 2011;38(9):905-10. https://doi.org/10.1111/j.1346... PMid:21658110.
 
36.
Gore M, Winters ME. Erythema gyratum repens: A rare paraneoplastic rash. West J Emerg Med. 2011;12(4):556-8. https://doi.org/10.5811/westje... PMid:22224159 PMCid:PMC3236141.
 
37.
Niculet E, Bobeica C, Tatu AL. Glucocorticoid-induced skin atrophy: The old and the new. Clin Cosmet Investig Dermatol. 2020;13:1041-50. https://doi.org/10.2147/CCID.S... PMid:33408495 PMCid:PMC7779293.
 
38.
Pectasides D, Koumpou M, Gaglia A, et al. Dermatomyositis associated with breast cancer. Anticancer Res. 2006;26:2329-31.
 
39.
Sandhu NP, Zakaria S, Degnim AC, Boughey JC. Dermatomyositis presenting as a paraneoplastic syndrome due to underlying breast cancer. BMJ Case Rep. 2011;2011:bcr1020103416. https://doi.org/10.1136/bcr.10... PMid:22714621 PMCid:PMC3062365.
 
40.
Richardson JB, Callen JP. Dermatomyositis and malignancy. Med Clin North Am. 1989;73(5):1211-20. https://doi.org/10.1016/S0025-... PMid:2671542.
 
41.
Vulink AJE, ten Bokkel Huinink D. Acquired hypertrichosis lanuginosa: A rare cutaneous paraneoplastic syndrome. J Clin Oncol. 2007;25(12):1625-6. https://doi.org/10.1200/JCO.20... PMid:17443005.
 
42.
Pilarski R, Burt R, Kohlman W, et al. Cowden syndrome and the PTEN hamartoma tumor syndrome: Systematic review and revised diagnostic criteria. J Natl Cancer Inst. 2013;105(21):1607-16. https://doi.org/10.1093/jnci/d... PMid:24136893.
 
43.
National Comprehensive Cancer Network. Genetic/familial high-risk asssessment: Breast and ovarian. Available at: http://www.nccn.org/profession... (Accessed: 7 November 2023).
 
44.
Rojas K, Stuckey A. Breast cancer epidemiology and risk factors. Clin Obstet Gynecol. 2016;59(4):651-72. https://doi.org/10.1097/GRF.00... PMid:27681694.
 
45.
Souto LRM. Invited discussion on: The impact of reconstructive modality and postoperative complications on decision regret and patient-reported outcomes. Aesthetic Plast Surg. 2022;46(2):661-6. https://doi.org/10.1007/s00266... PMid:35031824.
 
46.
Boccola MA, Savage J, Rozen WM, et al. Surgical correction and reconstruction of the nipple-areola complex: Current review of techniques. J Reconstr Microsurg. 2010;26(9):589-600. https://doi.org/10.1055/s-0030... PMid:20721849.
 
47.
Butler PD, Plana NM, Hastings AL. Finishing touches: Expanding access to nipple-areola tattooing as a component of postmastectomy breast reconstruction. Plast Reconstr Surg Glob Open. 2019;7(11):e2558. https://doi.org/10.1097/GOX.00... PMid:31942320 PMCid:PMC6908362.
 
48.
Stolier AJ, Sullivan SK, Dellacroce FJ. Technical considerations in nipple-sparing mastectomy: 82 consecutive cases without necrosis. Ann Surg Oncol. 2008;15(5):1341-7. https://doi.org/10.1245/s10434... PMid:18256883.
 
49.
Agarwal S, Pappas L, Neumayer L, Kokeny K, Agarwal J. Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer. JAMA Surg. 2014;149(3):267-74. https://doi.org/10.1001/jamasu... PMid:24429935.
 
50.
van Maaren MC, de Munck L, de Bock GH, et al. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands: A population-based study. Lancet Oncol. 2016;17(8):1158-70. https://doi.org/10.1016/S1470-... PMid:27344114.
 
51.
Hartmann-Johnsen OJ, Kåresen R, Schlichting E, Nygård JF. Survival is better after breast conserving therapy than mastectomy for early stage breast cancer: A registry-based follow-up study of Norwegian women primary operated between 1998 and 2008. Ann Surg Oncol. 2015;22(12):3836-45. https://doi.org/10.1245/s10434... PMid:25743325 PMCid:PMC4595537.
 
52.
Corradini S, Bauerfeind I, Belka C, et al. Trends in use and outcome of postoperative radiotherapy following mastectomy: A population-based study. Radiother Oncol. 2017;122(1):2-10. https://doi.org/10.1016/j.rado... PMid:27641786.
 
53.
Gu J, Groot G, Holtslander L, Engler-Stringer R. Understanding women’s choice of mastectomy versus breast conserving therapy in early-stage breast cancer. Clin Med Insights Oncol. 2017;11:1179554917691266. https://doi.org/10.1177/117955... PMid:28469511 PMCid:PMC5395266.
 
54.
Lee WQ, Tan VKM, Choo HMC, et al. Factors influencing patient decision-making between simple mastectomy and surgical alternatives. BJS Open. 2018;3(1):31-7. https://doi.org/10.1002/bjs5.5... PMid:30734013 PMCid:PMC6354187.
 
55.
Shaverdian N, Wang X, Hegde JV, et al. The patient’s perspective on breast radiotherapy: Initial fears and expectations versus reality. Cancer. 2018;124(8):1673-81. https://doi.org/10.1002/cncr.3... PMid:29479673.
 
56.
Agarwal S, Agarwal S, Neumayer L, Agarwal JP. Therapeutic nipple-sparing mastectomy: Trends based on a national cancer database. Am J Surg. 2014;208(1):93-8. https://doi.org/10.1016/j.amjs... PMid:24581994.
 
57.
Sisco M, Kyrillos AM, Lapin BR, Wang CE, Yao KA. Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States. Breast Cancer Res. Treat. 2016;160(1):111-20. https://doi.org/10.1007/s10549... PMid:27620883.
 
58.
Li M, Chen K, Liu F, Su F, Li S, Zhu L. Nipple sparing mastectomy in breast cancer patients and long-term survival outcomes: An analysis of the SEER database. PLoS One. 2017;12(8):e0183448. https://doi.org/10.1371/journa... PMid:28841691 PMCid:PMC5571910.
 
59.
Poortmans, PMP, Arenas M, Livi L. Over-irradiation. Breast. 2017;31:295-302. https://doi.org/10.1016/j.brea... PMid:27522160.
 
60.
Matros E, Shamsunder M, Disa JJ. The effect of the breast cancer provider discussion law on breast reconstruction rates in New York State. Plast Reconstr Surg. 2019;144(3): 569-70. https://doi.org/10.1097/PRS.00... PMid:31461003 PMCid:PMC6755661.
 
61.
Pusic AL, Matros E, Fine N, et al. Patient-reported outcomes 1 year after immediate breast reconstruction: Results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol. 2017;35(22):2499-506. https://doi.org/10.1200/JCO.20... PMid:28346808 PMCid:PMC5536162.
 
62.
Nguyen AT, Chang DW. Discussion: A paradigm shift in U.S. breast reconstruction: Increasing implant rates. Plast Reconstr Surg. 2013;131(1):24-5. https://doi.org/10.1097/PRS.0b... PMid:23271516.
 
63.
Albornoz CR, Bach PB, Mehrara BJ, et al. A paradigm shift in U.S. breast reconstruction: Increasing implant rates. Plast Reconstr Surg. 2013;131(1):15-23. https://doi.org/10.1097/PRS.0b... PMid:23271515.
 
64.
Overgaard M, Hansen PS, Overgaard J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy: Danish breast cancer cooperative group 82b trial. N Engl J Med. 1997;337(14):949-55. https://doi.org/10.1056/NEJM19... PMid:9395428.
 
65.
Overgaard M, Jensen MB, Overgaard J, et al. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish breast cancer cooperative group DBCG 82c randomised trial. Lancet. 1999;353(9165):1641-8. https://doi.org/10.1016/S0140-... PMid:10335782.
 
66.
EBCTCG (Early Breast Cancer Trialists’ Collaborative Group), McGale P, Taylor C, et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: Metaanalysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 2014;383(9935):2127-35. https://doi.org/10.1016/S0140-....
 
67.
Ragaz J, Jackson SM, Le N, et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med. 1997;337(14):956-62. https://doi.org/10.1056/NEJM19... PMid:9309100.
 
68.
Frasier LL, Holden S, Holden T, et al. Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines. JAMA Oncol. 2016;2(1):95-101. https://doi.org/10.1001/jamaon... PMid:26539936 PMCid:PMC4713236.
 
69.
Poppe MM, Agarwal JP. Breast reconstruction with postmastectomy radiation: Choices and tradeoffs. J Clin Oncol. 2017;35(22):2467-70. https://doi.org/10.1200/JCO.20... PMid:28481705.
 
70.
Alderman AK, Wilkins EG, Kim HM, et al. Complications in postmastectomy breast reconstruction: Two-year results of the Michigan breast reconstruction outcome study. Plast Reconstr Surg. 2002;109(7):2265-74. https://doi.org/10.1097/000065... PMid:12045548.
 
71.
Benediktsson K, Perbeck L. Capsular contracture around saline-filled and textured subcutaneously-placed implants in irradiated and nonirradiated breast cancer patients: Five years of monitoring of a prospective trial. J Plast Reconstr Aesthet Surg. 2006;59(1):27-34. https://doi.org/10.1016/j.bjps... PMid:16482787.
 
72.
Whitfield GA, Horan G, Irwin MS, et al. Incidence of severe capsular contracture following implant-based immediate breast reconstruction with or without postoperative chest wall radiotherapy using 40 gray in 15 fractions. Radiother Oncol. 2009;90(1):141-7. https://doi.org/10.1016/j.rado... PMid:18977547.
 
73.
Christante D, Pommier SJ, Samuelson BT, et al. Using complications associated with postmastectomy radiation and immediate breast reconstruction to improve surgical decision making. Arch Surg. 2010;145(9):873-8. https://doi.org/10.1001/archsu... PMid:20855758.
 
74.
Fowble B, Park C, Wang F, et al. Rates of reconstruction failure in patients undergoing immediate reconstruction with tissue expanders and/or implants and postmastectomy radiation therapy. Int J Radiat Oncol Biol Phys.2015;92(3):634-41. https://doi.org/10.1016/j.ijro... PMid:25936815.
 
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